A client in an urgent care clinic is complaining of heart palpitations, fatigue, and shortness of breath. A 12-lead electrocardiogram (ECG) shows no discernable P-waves, and an irregular ventricular rate. The nurse should understand that this finding represents which of the following conditions?
Atrial flutter
Atrial fibrillation
Unstable angina
Premature atrial contractions (PACS)
The Correct Answer is B
A. Atrial flutter typically presents with a regular atrial rate (usually around 250-350 beats per minute) and a characteristic "sawtooth" pattern of flutter waves (F-waves) on the ECG. This condition would not present with irregular ventricular rates and is less likely based on the ECG findings described.
B. Atrial fibrillation is identified by an irregularly irregular rhythm and the absence of P-waves on the ECG, which is replaced by erratic activity.
C. Unstable angina presents with chest pain or discomfort due to reduced blood flow to the heart muscles, usually related to atherosclerotic plaque rupture or erosion. It does not cause the ECG findings described (absence of P-waves and irregular ventricular rate).
D. PACs are early atrial depolarizations that can cause palpitations but do not typically result in the absence of P-waves or irregular ventricular rates as described in the scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Carbidopa itself does not cross the blood-brain barrier. Its primary role in Sinemet is to inhibit the peripheral breakdown of levodopa (the precursor of dopamine) into dopamine before it reaches the brain.
B. It is true that it may take a few weeks to see the full effects of this medication, as the body needs time to adjust to it.
C. Parkinson's disease is progressive, and as the disease advances, the dosage and frequency of levodopa with carbidopa may need to be adjusted to maintain symptom control. Over time, higher doses or additional medications may be required to manage symptoms effectively.
D. Levodopa does not protect Carbidopa; rather, Carbidopa protects Levodopa from early conversion to dopamine outside the brain, which would make it less effective.
Correct Answer is B
Explanation
A. Splenectomy is not a standard treatment for myasthenia gravis. The spleen's role is primarily related to immune function and blood filtration rather than the pathophysiology of MG.
B. Thymectomy is a surgical procedure that involves the removal of the thymus gland. The thymus gland plays a role in the development and regulation of the immune system. In some cases of myasthenia gravis, especially in younger patients or those with thymoma (a tumor of the thymus gland), thymectomy can lead to improvement or remission of symptoms. This procedure is considered in cases where myasthenia gravis is refractory to medication or in cases associated with thymoma.
C. Appendectomy is the surgical removal of the appendix and is not a treatment for myasthenia gravis. The appendix is not implicated in the pathophysiology of MG.
D. Cholecystectomy is the surgical removal of the gallbladder and is performed for conditions related to the gallbladder, such as gallstones or inflammation. It is not indicated for the treatment of myasthenia gravis.
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